RESUMEN
Objective To analyze the features of hidden blood loss in the elderly femoral intertrochanteric fractures treated with extramedullary dynamic hip screw (DHS), intramedullary nails (Gamma 3, PFN) and hip arthroplasty (LBFH). Methods The clinicle records of 193 elderly patients (ages ≥75 year old) with femoral intertrochanteric fractures treat by DHS,Gamma3, PFNA and LBFH in our hospital were retrospectively analyzed. The estimated blood loss were calculated by Gross equation, according to the height,weight and changes of blood routine test reoperative and postoperative,the differences of hidden blood loss among DHS group,Gamma 3 group, PFN group and LBFH group were compared. Results Total blood loss in intramedullary nail groups were significantly higher than DHS group [(766 ± 83) mL],P 0.05), The hidden blood loss were significantly higher in the intramedullary nail groups than those in the LBFH group [(453 ± 98) mL,accounting 54%] and DHS group [(429 ± 59) mL,accounting 56%] (P 0.05). Conclusion Noteworthy, the hidden blood loss is major part of perioperative total blood loss in the elderly femoral intertrochanteric fractures , intramedullary fixations may result in greater hidden blood loss than extramedullary fixations and hip arthroplasty ,which may cause postoperative anemia.